scholarly journals Outcome Evaluation of Patients with Burst Thoracolumbar Fractures: A Case Series

2018 ◽  
Vol 37 (04) ◽  
pp. 304-308
Author(s):  
Mohammad Jamali ◽  
Yashar Goorakani ◽  
Niloofar Solat ◽  
Reza Taheri ◽  
Sulmaz Ghahramani
Keyword(s):  
Functional Outcome ◽  
Visual Analog Scale ◽  
Thoracolumbar Spine ◽  
Case Series ◽  
Outcome Evaluation ◽  
Thoracolumbar Fractures ◽  
Analog Scale ◽  
Short Segment ◽  
Long Term Follow Up ◽  
The Mean

Objective The aim of the present study was to evaluate the outcome of short segment instrumentation in patients affected by burst thoracolumbar fractures. Methods A total of 19 patients with unstable burst fractures of the thoracolumbar spine were eligible for short segment instrumentation. Their functional outcome (by using the Oswestry and Denis scales) and back pain (using the visual analog scale) were evaluated after 12 months. Results The mean age of the patients was 30.7 years old, and most of them were male (n = 15). The mean hospital stay was 4.6 days. The mean ± standard deviation (SD) of the pain score according to the visual analog scale was 1.63 ± 1.25 after 12 months of surgery, and there were no patients classified with grades 4 or 5 on the Denis work scale. The average Oswestry disability index (ODI) was 17% during the follow-ups. Conclusions The outcome of the studied patients, including the clinical pain and the functional outcome of postsurgical patients, suggested that the short-segment instrumentation could be an appropriate method for patients with unstable thoracolumbar junction fractures. However, a long-term follow-up is recommended.

Treating traumatic thoracolumbar spine fractures using minimally invasive percutaneous stabilization plus balloon kyphoplasty: a 102-patient series

2021 ◽  
pp. neurintsurg-2020-017238
Author(s):  
Henri Salle ◽  
Alexandre Meynard ◽  
Emilie Auditeau ◽  
Clément Gantois ◽  
Aymeric Rouchaud ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Open Surgery ◽  
Body Height ◽  
Thoracolumbar Spine ◽  
Visual Analog Scale Score ◽  
Posterior Wall ◽  
Balloon Kyphoplasty ◽  
Expected Improvement ◽  
Thoracolumbar Fractures ◽  
Analog Scale

BackgroundThere is no consensus on the treatment for spinal injuries resulting in thoracolumbar fractures without neurological impairment. Many trauma centers are opting for open surgery rather than a neurointerventional approach combining posterior percutaneous short fixation (PPSF) plus balloon kyphoplasty (BK).ObjectiveTo assess the safety and efficacy of PPSF+BK and to estimate the expected improvement by clarifying the factors that influence improvement.MethodsWe retrospectively reviewed patients who underwent PPSF+BK for the treatment of single traumatic thoracolumbar fractures from 2007 to 2019. Kyphosis, loss of vertebral body height (VBH), clinical and functional outcomes including visual analog scale and Oswestry disability index were assessed. We examined the overall effects in all patients by constructing a linear statistical model, and then examined whether efficacy was dependent on the characteristics of the patients or the fractures.ResultsA total of 102 patients were included. No patient experienced neurological worsening or wound infections. The average rates of change were 74.4% (95% CI 72.6% to 76.1%) for kyphosis and 85.5% (95% CI 84.4% to 86.6%) for VBH (both p<0.0001). The kyphosis treatment was more effective on Magerl A3 and B2 fractures than on those classified as A2.3, as well as for fractures with slight posterior wall protrusion on the spinal canal. A higher postoperative visual analog scale score was predictive of poorer outcome at 1 year.ConclusionsThis is the largest series reported to date and confirms and validates this surgical treatment. All patients exhibited improved kyphosis and restoration of VBH. We advise opting for this technique rather than open surgery.

The Use of Intra-articular Hylan G-F 20 in the Treatment of Symptomatic Osteoarthritis of the Shoulder

2007 ◽  
Vol 35 (6) ◽  
pp. 979-985 ◽  
Author(s):  
Eric Silverstein ◽  
Robin Leger ◽  
Kevin P. Shea
Keyword(s):  
Visual Analog Scale ◽  
Case Series ◽  
Visual Analog Scale Score ◽  
Analog Scale ◽  
Level Of Evidence ◽  
Simple Shoulder Test ◽  
Ucla Score ◽  
Glenohumeral Osteoarthritis ◽  
The Mean

Background While hylan G-F 20 is an approved therapy for the treatment of knee osteoarthritis, there are few reports of its use in shoulder osteoarthritis. Hypothesis Hylan G-F 20 can reduce pain and improve function in patients with glenohumeral osteoarthritis. Study Design Case series; Level of evidence, 4. Methods Thirty consecutive patients with idiopathic glenohumeral osteoarthritis who failed to respond to standard conservative measures were enrolled. Patients received 3 weekly intra-articular hylan G-F 20 injections in their affected shoulder and completed a visual analog scale for pain, the UCLA score, and the Simple Shoulder Test at baseline and at 1, 3, and 6 months after the third injection. Results Of the 30 patients, 3 withdrew during the washout period before treatment; the remaining patients (17 men and 10 women) had an average age of 62 years. The mean baseline visual analog scale score was 54, UCLA score was 15.7, and Simple Shoulder Test score was 5.7 (of 12 possible “yes” responses). At the 6-month follow-up, hylan G-F 20 significantly improved visual analog scale (mean 30, P < .001), UCLA (mean 24, P < .001), and Simple Shoulder Test (7.6 “yes” responses, P < .001) scores. More patients slept comfortably after treatment (56%) versus before treatment (15%). Nine patients had a visual analog scale improvement >40 points after 6 months. No device-related adverse events were observed. Conclusion Hylan G-F 20 may have a beneficial therapeutic effect on some symptomatic patients with glenohumeral osteoarthritis.

A short-segment fusion strategy using a wide-foot-plate expandable cage for vertebral pseudarthrosis after an osteoporotic vertebral fracture

2020 ◽  
Vol 33 (6) ◽  
pp. 862-869
Author(s):  
Ryo Taiji ◽  
Masanari Takami ◽  
Yasutsugu Yukawa ◽  
Hiroshi Hashizume ◽  
Akihito Minamide ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Adverse Events ◽  
Spinal Fusion ◽  
Visual Analog Scale ◽  
Osteoporotic Vertebral Fracture ◽  
Analog Scale ◽  
Kyphotic Angle ◽  
Short Segment ◽  
Final Observation ◽  
The Mean

OBJECTIVEVarious surgical treatments have been reported for vertebral pseudarthrosis after osteoporotic vertebral fracture (OVF). However, the outcomes are not always good. The authors now have some experience with combined anterior-posterior short-segment spinal fusion (1 level above and 1 level below the fracture) using a wide-foot-plate expandable cage. Here, they report their surgical outcomes with this procedure.METHODSBetween June 2016 and August 2018, 16 consecutive patients (4 male and 12 female; mean age 75.1 years) underwent short-segment spinal fusion for vertebral pseudarthrosis or delayed collapse after OVF. The mean observation period was 20.1 months. The level of the fractured vertebra was T12 in 4 patients, L1 in 3, L2 in 4, L3 in 3, and L4 in 2. Clinical outcomes were assessed using the lumbar Japanese Orthopaedic Association (JOA) scale and 100-mm visual analog scale for low-back pain. Local kyphotic angle, intervertebral height, bone union rate, and instrumentation-related adverse events were investigated as imaging outcomes. The data were analyzed using the Wilcoxon signed-rank test.RESULTSThe mean operating time was 334.3 minutes (range 256–517 minutes), and the mean blood loss was 424.9 ml (range 30–1320 ml). The only perioperative complication was a superficial infection of the posterior wound that was cured by irrigation. The lumbar JOA score and visual analog scale value improved from 11.2 and 58.8 mm preoperatively to 20.6 and 18.6 mm postoperatively, respectively. The mean local kyphotic angle and mean intervertebral height were 22.6° and 28.0 mm, respectively, before surgery, −1.5° and 40.5 mm immediately after surgery, and 7.0° and 37.1 mm at the final observation. Significant improvement was observed in both parameters immediately after surgery and at the final observation when compared with the preoperative values. Intraoperative endplate injury occurred in 8 cases, and progression of cage subsidence of 5 mm or more was observed in 2 of these cases. Proximal junctional kyphosis was observed in 2 cases. There were no cases of screw loosening. No cases required reoperation due to instrument-related adverse events. Bone union was observed in all 14 cases that had CT evaluation.CONCLUSIONSThis short-segment fusion procedure is relatively minimally invasive, and local reconstruction and bone fusion have been achieved. This procedure is considered to be attempted for the surgical treatment of osteoporotic vertebral pseudarthrosis after OVF.

scholarly journals Does Tranexamic Acid Reduce Perioperative Bleeding in Short Segment Pedicle Screw Fixation in Thoracolumbar Spine Fractures?

2015 ◽  
Vol 53 (199) ◽  
pp. 169-173 ◽  
Author(s):  
Rabindra Lal Pradhan ◽  
Bimal Kumar Pandey
Keyword(s):  
Tranexamic Acid ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Thoracolumbar Spine ◽  
Pedicle Screw Fixation ◽  
Control Group ◽  
Thoracolumbar Fractures ◽  
Short Segment ◽  
Perioperative Bleeding ◽  
Thoracolumbar Spine Fractures

Introduction: Blood loss with spinal surgery is common potential cause of morbidity and often requires blood transfusion. Tranexamic acid (TXA), is effective in reducing bleeding in patients undergoing knee arthroplasty. TXA used in spine surgery studies have included different cases leading to inconsistence of surgical procedures. Purpose of this prospective observational study was to examine effect of TXA decreasing bleeding in short segment pedicle screw fixation for thoracolumbar fractures. Methods: 38 patients' undergoing short segment pedicle screw for thoracolumbar fractures were enrolled in study from July to August 2013. There were 28 male and 10 female patients, with an average age of 36.5 years. Patients received 10 mg/kg of TXA or a control 30 minutes intravenously before skin incision and 3 hours post-operative and oral medication for three days. Intraoperative bleeding was estimated by weighing surgical sponges, blood collected by suction container and by subtracting all irrigation fluid. Postoperative bleeding was measured from volume in vacuum drainage bag. Results: Twenty (20) patients were in control group and eighteen(18) to TXA group. There were no statistical differences between groups in terms of age, gender, co-morbidities, and operating time, preoperative Hemoglobin, PT and INR. Intra-operative bleeding in TXA group was significant than in control group. Post-operative drainage and Hemoglobin in first 48 h was reduced compared with placebo in TXA group. Need for post-operative transfusion was nil in TXA group. Conclusions: Administration of TXA before surgery significantly reduces perioperative bleeding in patients undergoing short segment pedicle screw fixation for thoracolumbar spine fractures.  Keywords: bleeding; spinal surgery; tranexamic acid.

Effect of Chlorophyllin on Urinary Odor in Incontinent Geriatric Patients

1983 ◽  
Vol 17 (10) ◽  
pp. 732-734 ◽  
Author(s):  
Milap C. Nahata ◽  
Carole A. Slencsak ◽  
Judith Kamp
Keyword(s):  
Visual Analog Scale ◽  
Washout Period ◽  
Geriatric Patients ◽  
Odor Intensity ◽  
Controlled Study ◽  
Analog Scale ◽  
Double Blind ◽  
Mean Intensity ◽  
The Mean ◽  
Percent Decrease

This randomized, double-blind, crossover, placebo-controlled study involved 20 incontinent geriatric patients; all had indwelling Foley catheters. Each patient received chlorophyllin 100 mg/d for two weeks and placebo daily for two weeks, separated by a washout period of one week. For each subject, the intensity of urinary odor was measured ten times during both the treatment and placebo regimen and three times during the washout period, using a visual analog scale. A decrease in urinary odor was associated with chlorophyllin in 12 patients and with placebo in 6 patients at the end of two weeks on each regimen. Chlorophyllin treatment was associated with about a 21-percent decrease in mean urinary odor intensity, whereas placebo increased the odor by about 9 percent. The mean intensity of urinary odor was lowest during the second week of chlorophyllin treatment. Despite the decrease in urinary odor in many patients receiving chlorophyllin, its effect was not significantly greater than that of placebo. Our data suggest that chlorophyllin 100 mg/d for two weeks may not be effective in incontinent geriatric patients with mild to moderate urinary odor.

Total subaxial reconstruction

2010 ◽  
Vol 13 (4) ◽  
pp. 424-434 ◽  
Author(s):  
Vincent C. Traynelis
Keyword(s):  
Cervical Spine ◽  
Visual Analog Scale ◽  
Anterior Decompression ◽  
Analog Scale ◽  
Excellent Outcome ◽  
Arm Pain ◽  
Subaxial Cervical Spine ◽  
Pain Scores ◽  
The Mean

Object Certain cervical spinal conditions require decompression and reconstruction of the entire subaxial cervical spine. There are limited data concerning the clinical details and outcomes of patients treated in this manner. The object of this study was to describe the specific technique employed to perform a total subaxial reconstruction and review the postoperative outcomes following surgery. Methods The author performed a review of data prospectively collected in 27 consecutive patients undergoing complete anterior decompression and reconstruction of the anterior cervical spine and followed by posterior instrumented arthrodesis with or without decompression. Results There were 16 men and 11 women whose mean age was 59 years (range 35–86 years). The minimum follow-up was 12 months and the mean follow-up period for all patients was 26 months. One patient underwent C2–7 surgery, and in all others the procedure crossed the cervicothoracic junction. Following surgery patients remained intubated for an average of 3.3 days (range 1–22 days). The mean hospital length of stay was 11 days (range 3–45 days). One patient died 6 weeks following an uneventful surgery. Pneumonia developed in 5 patients, 1 patient experienced a minor pulmonary embolism, and 2 patients had posterior wound infections. No patient was neurologically worse following surgery. A single patient presented with a C-8 radiculopathy 6 weeks after surgery. At final follow-up no patient complained of dysphagia when specifically questioned about this potential problem. In all patients solid fusions developed at each treated levels. Preoperatively the mean sagittal Cobb angle was 15.4° (kyphosis) and the postoperative mean angle was −10.9° (lordosis) representing a total average correction of over 25° (p < 0.0001). The mean preoperative Neck Disability Index was 27.6; this score decreased to 15.5 (p = 0.0008) postoperatively. The mean pre- and postoperative visual analog scale neck pain scores were 6.0 and 2.1, respectively (p = 0.0004), and mean visual analog scale arm pain scores decreased by 3.7 following surgery (p = 0.001). Based on Odom criteria, the author found that 8 patients had an excellent outcome and 14 patients a good outcome. There were 4 patients in whom the outcome was judged to be fair and the single death was recorded as a poor outcome. The mean preoperative Nurick score was 2.68. Postoperatively the group improved to an average score of 1.5; the difference between the 2 was statistically significant (p = 0.002). Conclusions Segmental anterior decompression and reconstruction of the entire subaxial cervical spine, combined with an instrumented posterolateral fusion, can be performed with acceptable morbidity and is of significant benefit in selected patients.

scholarly journals Use of cuff tear arthroplasty head prosthesis for rotator cuff arthropathy treatment in elderly patients with comorbidities

2016 ◽  
Vol 14 (4) ◽  
pp. 520-527 ◽  
Author(s):  
Cassiano Diniz Carvalho ◽  
◽  
Carlos Vicente Andreoli ◽  
Alberto de Castro Pochini ◽  
Benno Ejnisman
Keyword(s):  
Rotator Cuff ◽  
Visual Analog Scale ◽  
Analog Scale ◽  
Shoulder Hemiarthroplasty ◽  
Scale Reduction ◽  
Cuff Tear ◽  
Functional Behavior ◽  
Significant Difference ◽  
The Mean ◽  
Rotator Cuff Arthropathy

ABSTRACT Objective To evaluate the clinical and functional behavior of patients undergoing cuff tear arthroplasty at different stages of the disease. Methods Cuff tear arthroplasty hemiarthroplasties were performed in 34 patients with rotator cuff arthropathy and associated comorbidities, classified according to Seebauer. The mean age was 76.3 years, and the sample comprised 23 females (67.6%) and 11 males (32.4%). The mean follow-up period was 21.7 months, and evaluations were performed using the Visual Analog Scale for pain and the Constant scale. Results There were no statistically significant differences in the mean reduction in the Visual Analog Scale or in the Constant scale increase between the female and male groups. The variation between the pre- and postoperative Visual Analog Scale and Constant scale evaluations was significant. There was also no statistically significant difference between the Seebauer classification groups regarding the mean Visual Analog Scale reduction, or the mean Constant scale increase. Conclusion Cuff tear arthroplasty shoulder hemiarthroplasty is a good option for rotator cuff arthropathy in patients with comorbidities.

scholarly journals Outcome of Unstable Thoracolumbar Fracture Following Long Segment Posterior Fixation

2021 ◽  
Vol 39 (2) ◽  
pp. 114-122
Author(s):  
Abdullah Al Mamun Choudhury ◽  
Md Shah Alam ◽  
Abul Kalam Azad ◽  
Kohinoor Akhter
Keyword(s):  
Functional Outcome ◽  
Neurological Deficit ◽  
Thoracolumbar Spine ◽  
Case Series ◽  
Fusion Rate ◽  
Spine Injury ◽  
P Value ◽  
Posterior Fixation ◽  
Thoracolumbar Region

Introduction: Fractures of the thoracolumbar region are the most common injuries of the vertebral column and burst fractures are the most frequent. The purpose of this study was to see the radiological and functional outcome after long segment posterior fixation in unstable thoracolumbar spine injury with incomplete neurological deficit. Methods: A total of 146 cases were included in this prospective case series from January 2014 to December 2018 through non randomized purposive sampling. All the patients were operated with long segment posterior fixation and postero-lateral fusion by Autogenous cancellous bone graft. Postoperative functional outcome was assessed both clinically by ODI, VAS, ASIA and radiologically by Bridwell criteria. Postoperative follow up was conducted at 2nd, 6th,12th and finally 6 monthly. Results: The mean Cobb angle at pre-operative was 21.5 ±8.9 and at final follow-up was 11±4.57 in this study (p-value<0.05). At final follow up 1 grade improvement occurred in 116(79.5%) patients and 2 grade improvement in 36 (20.5%). Regarding ODI and VAS, moderate disability (25%) with mild pain (16%) was found at final follow up with a Bridwell fusion grade II (48%). Conclusion: Long segment transpedicular screw fixation in unstable thoracolumbar spine injury with incomplete neurological deficit is an effective method of treatment. This method enhances neurological and functional recovery with an acceptable fusion rate J Bangladesh Coll Phys Surg 2021; 39(2): 114-122

scholarly journals Long-term follow-up of neodymium:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis

2018 ◽  
Vol 46 (9) ◽  
pp. 3692-3697 ◽  
Author(s):  
Hehua Ye ◽  
Jiming Zhang ◽  
Yiyong Qian
Keyword(s):  
Nd:Yag Laser ◽  
Case Series ◽  
Anterior Capsule ◽  
Long Term Study ◽  
Before And After ◽  
Long Term Follow Up ◽  
The Mean ◽  
Anterior Capsulotomy

Objective To investigate the long-term safety and efficacy of Nd:YAG laser anterior capsulotomy for the treatment of anterior capsular phimosis. Methods We retrospectively analyzed a consecutive case series of Nd:YAG laser anterior capsulotomy in patients with anterior capsular phimosis, who were treated between November 2012 and April 2014. Data collected included risk factors, interval between surgery and capsulotomy, best-corrected visual acuity (BCVA), and diameter of anterior capsule opening before and after Nd:YAG laser anterior capsulotomy. Results Eleven eyes of 11 patients were included in the study. The mean follow-up time was 30.1 ± 4.5 months (range: 26–42 months). At the last follow-up, the mean diameter of the anterior capsule opening was 5.1 ± 0.2 mm, which was significantly greater than the diameter before laser capsulotomy (2.2 ± 0.8 mm). BCVA remained stable or improved in nine eyes (81.8%) following capsulotomy. No patients experienced recurrence of phimosis. Conclusions In a long-term study of >2 years, we found that Nd:YAG laser anterior capsulotomy is safe and effective for the treatment of anterior capsule phimosis.

scholarly journals KOMPARASI ELECTROSURGERY, ABRASIVE BUR DAN SCALPEL TECHNIQUE PADA DEPIGMENTASI GUSI DENGAN TEKNIK SPLIT MOUTH (Case Series)

2018 ◽  
Vol 14 (1) ◽  
pp. 20
Author(s):  
RM Norman Tri Kusumo Indro
Keyword(s):  
Wound Healing ◽  
Visual Analog Scale ◽  
Gold Standard ◽  
Case Series ◽  
Analog Scale ◽  
Healing Index

Pendahuluan dan tujuan : pigmentasi gingiva merupakan keluhan estetik utama terutama orang Asia. Pigmentasi melanin disebabkan oleh berlebihnya granul melanin didalan lapisan epitelium gingiva. Senyum yang harmonis dipengaruhi tidak hanya dari bentuk, posisi ,warna dari gigi, akan tetapi gusi berpengaruh. Pigmentasi melanin bukan merupakan kelainan patologis dan tidak berbahaya, penanganan secara estetik dapat dilakukan dengan hasil yang sangat baik. Penatalaksanaan : kasus ini menjelaskan teknik split mouth  pada prosedur depigmentasi dengan tiga teknik yang berbeda. Prosedur dengan pisau bedah,dan dengan mata bur. kedua teknik ini dinilai efektif untuk menangani kasus depigmentasi gingiva. Pengukuran komparasi akan diukur dari wound healing index and visual analog scale. Kesimpulan : teknik dengan pisau bedah merupakan teknik yang paling umum dan memberikan hasil yang baik, kelemahan teknik pisau bedah adalah waktu operasi yang cukup lama. Prosedur dengan bur merupakan teknik yang mulai sering digunakan, teknik ini tidak memakan waktu serta hasil maksimal. Kelemahan teknik ini membutuhkan presisi. Kasus ini akan membahas mengenai kekurangan dan kelebihan dari ketiga teknik tersebut dengan mempertahankan prosedur pisau bedah sebagai terapi gold standard untuk depigmentasi.

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